Healthcare Identifiers Bill

This Bill seeks to establish a profile system of unique identifiers for individuals within the health system. To me, it makes makes perfect sense, as we can now track an individual going through the system and his or her interaction with doctors, dentists, nurses, pharmacists and opticians. We’ll know if the person is undergoing any treatment currently and if they have reacted badly to a particular medicine in the past.
Implementation of a unique identifier system is recognised as
being an essential infrastructural initiative which will facilitate many
significant improvements to the health system in areas such as
patient safety and improved data access and quality leading to
improved overall systems efficiency. It is also a fundamental
requirement for deploying eHealth solutions and an essential
building block for Money Follows the Patient and Universal Health
Insurance, both cornerstones of the Government Reform Agenda. In truth, it’s surprising that this wasn’t already the case for a long time, and I imagine a great many Irish people presume a system of this type was already in operation.
A story from last April in the Irish Examiner, however, made it plainly obvious that this system wasn’t in effect. The journalist Niamh Drohan, posing as a student, visited seven GPs displaying symptoms of depression which she had read about on the internet. She then subsequently received prescriptions from all seven GPs, with few advising on maximum dosage and none advising on potential side effects. The article posed a number of interesting issues, but more than anything else it exposed how somebody – if they so wished – could effectively game the system and receive multiple prescriptions.

As she wrote at the time, of the seven phone calls she made, seeking an appointment, just two enquired if medical records needed to be transferred over. In relation to the prescriptions: three of them were issued for one month, one prescription was for two months, another was for three months and yet another for six months. This gave her a total of 20 months’ worth of antidepressant medication without revisiting any GP. How incredible. In one case, a three-month prescription was given in less than 10 minutes. This Bill should effectively clamp down on that in a very simple way, and ultimately stop anybody from abusing the system.

When looking to countries which have implemented this system both in an effective and a cost effective way, it would perhaps be helpful to look at Estonia, who implemented a similar system almost a decade ago, the Estonian Electronic Health Record System has proven to be a great success, saving money and improving efficiencies right across the Estonian Health Sector.

It is clear that this is a building block, and a first step towards deploying e-health solutions, which could provide us with better data access, better healthcare analytics and overall a better and more efficient healthcare system. In addition, it is also a platform for Universal Health Insurance, which is a cornerstone of the agenda and something which we are committed to.

While healthcare reform has faced many obstacles so far, we have been successful in reducing waiting times across the country and in a few months time will be introducing free GP care for those 6 years and under.

This Bill will also be a useful part in the holistic healthcare strategy, as it allows us to focus on the patient, ensure the system is running efficiently and also, potentially, highlight anomalies within the system in a very efficient way by giving us very straightforward data which can be analysed and potentially debated, something which we lack right now, where a lot of healthcare debates are based on anecdotal evidence and old statistics. In terms of data protection, an important provision is that The National Register of Individual Health Identifiers (IHIs) will be accessible only to specified persons under the Bill and to the Minister and section 12 persons (subject to agreement). This will allow healthcare experts up-to-date, real time knowledge about both the individual patients and the system as a whole, and this must be welcomed.

Privacy concerns are important of course, and that’s why consultations have been held with the relevant Data Protection Authorities and why we need to ensure that we adhere to the best data protection governance internationally, which I am confident that this will.